Tags: Breathing and sucking, Caudal anaesthesia, Drug, epidural block, LABOUR, Medicine, morphine, pain relief, vagina
Some types of pain relief will only be available in large or teaching hospitals, others are widely available in all hospitals. Your midwife will also be able to offer you certain types during a home delivery.
Regional anaesthetics
These remove sensation from part of your body by blocking the transmission of pain from nerve fibres. Caudal anaesthesia is administered by an injection into your spinal area around the sacrum, and numbs your vagina and perineum. This may be used for short-term relief if the birth involves a vacuum extraction or forceps delivery.
To administer a pudendal block, anaesthesia is injected straight into your vagina near the pelvic region, blocking the pudendal nerve. This numbs the lower part of your vagina, and may be used if you have an episiotomy.
The most widely used form of this type of anaesthesia is the epidural block. Most mothers who have a Caesarean have an epidural instead of a general anaesthetic, which allows them to stay awake throughout the birth.
Anaesthetic is syringed into the catheter, which is then sealed, although it can be topped up at any time if necessary. You need to let your attendants know in advance that you wish to have an epidural because it must be given by a skilled anaesthetist, and it usually takes 10-20 minutes to be set up. The anaesthetic will take effect within a few minutes.
Inhalation analgesic
This is a gas that you administer yourself using a face mask, and consists of Entonox (gas and oxygen). You inhale deeply as the contraction starts, and carry on until the contraction peaks or you have had enough. You then put the mask aside and breathe normally. Gas works by numbing the pain centre in the brain, and can make you feel as though you’re floating. You may be able to practise this in an antenatal class.
Narcotics
Now considered rather old-fashioned, the most commonly used is pethidine, which is derived from morphine, and is given by injection in the thigh or buttock in varying dosages during the first stage of labour. It dulls the sensation of pain by acting on the nerve cells in the brain and spine. If you choose this, it is probably wise to ask for a small dose to see how you are affected. It will take about 20 minutes to work.
How drugs affect your baby
Most drugs will cross the placenta to affect your baby once they are in your bloodstream. Those used in epidural anaesthesia cannot enter your baby’s blood.
Drowsiness
A large dose of sedatives or tranquillizers may affect his ability to suckle, and to respond to you immediately after he is born.
If you take pethidine late in your labour it could affect your baby at birth because narcotics can depress your baby’s breathing and make sucking inefficient.
Epidural anaesthetic
After an injection of local anaesthetic in your back (to numb it), the anaesthetist will insert a fine, hollow needle into the epidural space — the region around the spinal cord — and the anaesthetic is injected through this.
